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pediatric heart failure

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https://www.readbyqxmd.com/read/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#1
Alfred Asante-Korang, Jennifer Carapellucci, Diane Krasnopero, Abigail Doyle, Brian Brown, Ernest Amankwah
There are only a few reports of successful use of mammalian target of rapamycin (mTORI) as primary immunosuppression in pediatric heart transplantation. Compared to calcineurin inhibitors, mTORI have less side effects, especially nephrotoxicity, infections and malignancies. A retrospective study was conducted at our institution of all 170 heart transplants from 1995-2015. Nineteen patients were switched from tacrolimus(n=15) or cyclosporin(n=4) to everolimus(n=4) or sirolimus(n=15) due to nephrotoxicity(n=5), malignancy(n=8), EBV viremia/reactive plasmacytic changes(n=5) and immune hemolytic anemia(n=1)...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28708228/clinical-and-subclinical-cardiac-late-effects-in-pediatric-hodgkin-s-lymphoma-survivors
#2
Carlo Materazzo, Maura Massimino, Elisabetta Schiavello, Marta Podda, Lorenza Gandola, Graziella Cefalo, Serena Catania, Cristina Meazza, Ivan Moschetti, Monica Terenziani
PURPOSE: Cardiac late effects are responsible for a significant burden of mortality and morbidity among pediatric Hodgkin's lymphoma (HL) survivors (HLS). The aim of our study was to assess clinical and subclinical cardiac sequelae in a cohort of childhood HLS treated in the 1980s with doxorubicin, bleomycin, vinblastine, and dacarbazine (the ABVD regimen) and limited-field radiotherapy (RT). METHODS: We retrospectively examined a series of HLS treated from 1979 to 1989...
July 8, 2017: Tumori
https://www.readbyqxmd.com/read/28699839/validated-low-volume-immunoassay-for-the-reliable-determination-of-direct-renin-especially-valuable-for-pediatric-investigations
#3
J Schaefer, B B Burckhardt, J Tins, A Bartel, S Laeer
INTRODUCTION: The pharmacotherapy of pediatric patients suffering from heart failure is extrapolated from adults due to missing data in children. OBJECTIVES: Development and validation of a low-volume immunoassay for the reliable determination of renin. EXPERIMENTAL: The immunoassay was validated according to international guidelines. RESULTS: The assay allows the reliable determination of renin in 40 μL plasma within a calibration range of 4 - 128 pg/mL...
July 12, 2017: Journal of Immunoassay & Immunochemistry
https://www.readbyqxmd.com/read/28699323/intra-procedural-continuous-dialysis-to-facilitate-interventional-catheterization-in-pediatric-patients-with-severe-renal-failure
#4
Angeline D Opina, Athar M Qureshi, Eileen Brewer, Ewa Elenberg, Sarah Swartz, Mini Michael, Henri Justino
BACKGROUND: Interventional catheterization procedures may be needed for patients with severe renal failure who are dependent on dialysis. To avoid the risk of fluid overload and electrolyte derangement during complex procedures in this oliguric/anuric patient population, we performed intra-procedural dialysis, either continuous renal replacement therapy (CRRT) or continous cycling peritoneal dialysis (CCPD). METHODS: We performed a retrospective review of a cohort of pediatric patients, ages 0-18 years, with dialysis-dependent renal failure who received CRRT or CCPD during catheterization procedures from January 2013 to March 2016...
July 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28696878/asynchronous-pumping-of-a-pulsatile-ventricular-assist-device-in-a-pediatric-anastomosis-model
#5
Bryan C Good, William J Weiss, Steven Deutsch, Keefe B Manning
BACKGROUND: Both pulsatile and continuous flow ventricular assist devices are being developed for pediatric congenital heart defect patients. Pulsatile devices are often operated asynchronously with the heart in either an "automatic" or a fixed beat rate mode. However, most studies have only investigated synchronized ejection. METHODS: A previously validated viscoelastic blood solver is used to investigate the parameters of pulsatility, power loss, and graft failure in a pediatric aortic anastomosis model...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28687669/atrioventricular-nodal-reentrant-tachycardia-in-patients-with-congenital-heart-disease-outcome-after-catheter-ablation
#6
John Papagiannis, Daniel Joseph Beissel, Ulrich Krause, Michel Cabrera, Marta Telishevska, Stephen Seslar, Christopher Johnsrude, Charles Anderson, Svjetlana Tisma-Dupanovic, Diana Connelly, Dimosthenis Avramidis, Christopher Carter, Laszlo Kornyei, Ian Law, Nicholas Von Bergen, Jan Janusek, Jennifer Silva, Eric Rosenthal, Mark Willcox, Peter Kubus, Gabriele Hessling, Thomas Paul
BACKGROUND: The relationship of atrioventricular nodal reentrant tachycardia to congenital heart disease (CHD) and the outcome of catheter ablation in this population have not been studied adequately. METHODS AND RESULTS: A multicenter retrospective study was performed on patients with CHD who had atrioventricular nodal reentrant tachycardia and were treated with catheter ablation. There were 109 patients (61 women), aged 22.1±13.4 years. The majority, 86 of 109 (79%), had CHD resulting in right heart pressure or volume overload...
July 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28672079/acute-kidney-injury-in-congenital-cardiac-surgery-comparison-of-prifle-akin
#7
Murat Tanyildiz, Mesiha Ekim, Tanil Kendirli, Ercan Tutar, Zeynep Eyileten, Zeynep Birsin Ozcakar, Asli Kavaz, Fatos Yalcınkaya, Adnan Uysalel, Semra Atalay
BACKGROUND: Acute kidney injury (AKI) is associated with an increased risk of mortality especially in pediatric intensive care units. The aim of this study is to determine the risk factors of AKI in children undergoing cardiac surgery for congenital heart disease and compare two different classification systems: pRIFLE and AKIN. METHODS: We retrospectively analyzed 145 patient undergoing pediatric congenital heart surgery who were between 1 month and 18 years and treated by the cardiovascular surgery department from January 2009 to October 2011...
July 3, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28669438/heading-toward-the-future-of-pediatric-heart-failure-with-continuous-flow-ventricular-assist-devices
#8
EDITORIAL
Ryan R Davies
No abstract text is available yet for this article.
June 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28669108/novel-genetic-variants-in-bag3-and-tnnt2-in-a-swedish-family-with-a-history-of-dilated-cardiomyopathy-and-sudden-cardiac-death
#9
Eva Fernlund, A Wålinder Österberg, E Kuchinskaya, M Gustafsson, K Jansson, C Gunnarsson
Familial dilated cardiomyopathy is a rare cause of dilated cardiomyopathy (DCM), especially in childhood. Our aim was to describe the clinical course and the genetic variants in a family where the proband was a four-month-old infant presenting with respiratory problems due to DCM. In the family, there was a strong family history of DCM and sudden cardiac death in four generations. DNA was analyzed initially from the deceased girl using next-generation sequencing including 50 genes involved in cardiomyopathy...
July 1, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28669107/outcomes-and-costs-of-cardiac-surgery-in-adults-with-congenital-heart-disease
#10
Viviane G Nasr, David Faraoni, Anne Marie Valente, James A DiNardo
Advances in pediatric cardiac surgical and medical care have led to increased survival of patients with congenital heart disease (CHD). Consequently, many CHD patients survive long enough to require cardiac surgery as adults. Using the 2013 Nationwide Inpatient Sample (NIS) database, we compared costs and outcomes for adult patients undergoing surgery for treatment of CHD to a reference population of adults undergoing CABG. Patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) procedure codes...
July 1, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28668199/chronic-respiratory-failure-utilization-of-a-pediatric-specialty-integrated-care-program
#11
Robert J Graham, Michael L McManus, Angie Mae Rodday, Ruth Ann Weidner, Susan K Parsons
OBJECTIVE: Describe utilization and satisfaction in a specialty integrated care program for children with severe, chronic respiratory insufficiency (CRI). SUBJECTS: Enrollees of the Critical Care, Anesthesia, Perioperative Extension (CAPE) and Home Ventilation Program. METHODS: Children with CRI received home visits, care coordination, and "on-demand" 24/7 access to physicians. Program activity and outcomes were recorded for 3 years using an adapted Care Coordination Measurement Tool© version...
March 2017: Healthcare
https://www.readbyqxmd.com/read/28664445/pediatric-cardiology-provider-attitudes-about-palliative-care-a-multicenter-survey-study
#12
Emily Morell Balkin, James N Kirkpatrick, Beth Kaufman, Keith M Swetz, Lynn A Sleeper, Joanne Wolfe, Elizabeth D Blume
While availability of palliative care consultation for children with advanced heart disease increases, little is known about cardiologist attitudes towards palliative care. We sought to describe perspectives of cardiologists regarding palliative care and to characterize their perceived competence in palliative care concepts. A cross-sectional survey of pediatric cardiologists and cardiac surgeons from 19 pediatric medical centers was performed. Overall response rate was 31% (183/589). Respondents had a median of 18 years of experience since medical school (range 2-49) and most practiced at academic centers (91%)...
June 29, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28659014/optimizing-nutrition-in-pediatric-heart-failure-the-crisis-is-over-and-now-it-s-time-to-feed
#13
Kylie D Lewis, Jennifer Conway, Chentel Cunningham, Bodil M K Larsen
Pediatric heart failure is a complex disease occurring when cardiac output is unable to meet the metabolic demands of the body. With improved surgical interventions and medical therapies, survival rates have improved, and care has shifted from focusing on survival to optimizing quality of life and health outcomes. Based on current literature, this review addresses the nutrition needs of infants and children in heart failure and describes the pathophysiology and metabolic implications of this disease. The prevalence of wasting in pediatric heart failure has been reported to be as high as 86%, highlighting the importance of nutrition assessment through all stages of treatment to provide appropriate intake of energy, protein, and micronutrients...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28658196/late-term-gestation-is-associated-with-improved-survival-in-neonates-with-congenital-heart-disease-following-postoperative-extracorporeal-life-support
#14
Jane M McKenzie, Thomas Scodellaro, Yves d'Udekem, Roberto Chiletti, Warwick Butt, Siva P Namachivayam
OBJECTIVE: Several population-based studies have shown that gestational age 39-40 weeks at birth is associated with superior outcomes in various pediatric settings. A high proportion of births for neonates with congenital heart disease occur before 39 weeks. We aimed to assess the influence of late-term gestation (39-40 wk) on survival in neonates requiring extracorporeal life support following surgery for congenital heart disease. DESIGN: Retrospective cohort study...
June 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28654552/severe-upper-airway-obstruction-after-intraoperative-transesophageal-echocardiography-in-pediatric-cardiac-surgery-a-retrospective-analysis
#15
Jörg Michel, Michael Hofbeck, Christian Schineis, Matthias Kumpf, Ellen Heimberg, Harry Magunia, Eckhard Schmid, Christian Schlensak, Gunnar Blumenstock, Felix Neunhoeffer
OBJECTIVES: The aim of this study was to evaluate if there is a correlation between the use of intraoperative transesophageal echocardiography and an increased rate of extubation failure and to find other risk factors for severe upper airway obstructions after pediatric cardiac surgery. DESIGN: Retrospective analysis. SETTING: Cardiac PICU. PATIENTS: Patients 24 months old or younger who underwent surgery for congenital heart disease with cardiopulmonary bypass were retrospectively enrolled and divided into two groups depending on whether they received an intraoperative transesophageal echocardiography or not...
June 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28634172/identifying-an-oxygenation-index-threshold-for-increased-mortality-in-acute-respiratory-failure
#16
Brandon G Hammond, Pamela Garcia-Filion, Paul Kang, Mounica Y Rao, Brigham C Willis, Heidi J Dalton
BACKGROUND: The objective of this work was to examine current oxygenation index (OI) data and outcomes using electronic medical record data to identify a specific OI value associated with mortality. METHODS: This study was a retrospective electronic medical record data review from the pediatric ICU of Phoenix Children's Hospital, with data mining for variables to calculate OIs on subjects age 1 month to 20 y mechanically ventilated >24 h, excluding those with known intracardiac shunts or cyanotic heart disease...
June 20, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28617694/the-spectrum-of-general-surgery-interventions-in-pediatric-patients-with-ventricular-assist-devices
#17
Fady Kamel, Holger Buchholz, Bryan Dicken, Jennifer Conway
Ventricular assist devices (VADs) have positively impacted the management of heart failure. However, they come with a range of complications. Although general surgical complications have been assessed in adults with VADs, there is no study to date that has assessed general surgery intervention in the pediatric population. Fifty-two patients who received VADs from 2005 to 2015 at the Stollery Children's Hospital were assessed for general surgery intervention and anticoagulation status at the time of intervention...
June 13, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28617685/adult-congenital-heart-disease-magnitude-of-the-problem
#18
Akanksha N Thakkar, Ponraj Chinnadurai, C Huie Lin
PURPOSE OF REVIEW: To define the magnitude of problems faced by patients with adult congenital heart disease (ACHD) and to identify unmet needs for this population. RECENT FINDINGS: The ACHD population is estimated to include more than 1 million people in the United States and continues to grow at a steady rate. Owing to the decline in early mortality in this group, modern medicine is now faced by the long-term complications associated with congenital heart disease such as chronic heart failure, increased endocarditis risk, elevated burden of arrhythmias, pulmonary hypertension, valvular dysfunction, and pregnancy...
June 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28614113/role-of-octreotide-in-pediatric-gastrointestinal-bleeding-secondary-to-angiodysplasia-in-children-with-right-heart-failure
#19
Kanika Puri, Robert Caldwell, Jean P Molleston
OBJECTIVES: Angiodysplasia is a relatively uncommon cause of GI bleeding in children and may be seen in right heart failure. Octreotide has been used successfully in adult patients with gastrointestinal bleeding due to angiodysplasias. METHODS: We describe two patients who had congenital heart disease with right heart failure and gastrointestinal bleeding from angiodysplasia. RESULTS: Angiodysplasia lesions were documented on traditional endoscopy and capsule endoscopy...
June 13, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28603625/physiological-impact-of-high-flow-nasal-cannula-therapy-on-postextubation-acute-respiratory-failure-after-pediatric-cardiac-surgery-a-prospective-observational-study
#20
Naohiro Shioji, Tatsuo Iwasaki, Tomoyuki Kanazawa, Kazuyoshi Shimizu, Tomohiko Suemori, Kentaro Sugimoto, Yasutoshi Kuroe, Hiroshi Morimatsu
BACKGROUND: Reintubation after pediatric cardiac surgery is associated with a high rate of mortality. Therefore, adequate respiratory support for postextubation acute respiratory failure (ARF) is important. However, little is known about the physiological impact of high-flow nasal cannula (HFNC) therapy on ARF after pediatric cardiac surgery. Our working hypothesis was that HFNC therapy for postextubation ARF after pediatric cardiac surgery improves hemodynamic and respiratory parameters...
2017: Journal of Intensive Care
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